What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

Venipuncture for blood work should be performed on the affected arm.

The blood pressure (BP) cuff should not be applied to the affected arm.

The affected arm should be held down close to the woman's side.

The affected arm should be used for intravenous (IV) therapy.

Answer and Explanation

The Correct Answer is B

Choice A reason: This is incorrect because venipuncture for blood work should be avoided on the affected arm. The mastectomy may have involved the removal of lymph nodes, which can impair the lymphatic drainage and increase the risk of lymphedema (swelling) in the arm. Venipuncture can cause further damage or infection to the arm.

Choice B reason: This is correct because the BP cuff should not be applied to the affected arm. The BP cuff can exert pressure on the arm and interfere with the blood and lymph flow. This can also increase the risk of lymphedema or pain in the arm.

Choice C reason: This is incorrect because the affected arm should not be held down close to the woman's side. The woman should be encouraged to elevate the arm above the level of the heart and perform gentle exercises to promote circulation and prevent stiffness. The arm should not be immobilized or restricted.

Choice D reason: This is incorrect because the affected arm should not be used for IV therapy. IV therapy can introduce fluids or medications into the arm that can affect the blood and lymph flow. It can also cause irritation or infection to the arm.

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Correct Answer is D

Explanation

Choice A reason: This is incorrect because oral antiviral therapy is not effective for PID, which is caused by bacterial infection. Antiviral therapy is used for viral infections, such as herpes or HIV.

Choice B reason: This is incorrect because antibiotics only until symptoms subside is not sufficient for PID, which can cause serious complications, such as infertility, ectopic pregnancy, or chronic pelvic pain. Antibiotics should be continued for the full course of treatment, usually 14 days, to ensure complete eradication of the infection.

Choice C reason: This is incorrect because frequent pelvic examination to monitor the progress of healing is not recommended for PID, which can cause inflammation and irritation of the pelvic organs. Pelvic examination should be avoided or minimized to prevent further trauma or spread of the infection.

Choice D reason: This is correct because bed rest in a semi-Fowler position is beneficial for PID, which can cause fluid accumulation and pressure in the pelvic cavity. Bed rest helps to reduce inflammation and pain, while semi-Fowler position helps to drain the fluid and prevent abscess formation.

A. Eat five small meals daily. B. Lie down after each meal. C. Reduce the amount of fiber she consumes. D. Substitute other calcium sources for milk in her diet.

Correct Answer is A

Explanation

Choice A reason: Eating five small meals daily can help reduce heartburn in pregnancy by preventing overeating and reducing the pressure on the stomach from the growing uterus. It can also help maintain a steady blood glucose level and prevent nausea and vomiting.

Choice B reason: Lying down after each meal can worsen heartburn in pregnancy by allowing the stomach acid to reflux into the esophagus. It can also cause breathing difficulties and increase the risk of aspiration. The woman should avoid lying down for at least two hours after eating and elevate her head and chest when sleeping.

Choice C reason: Reducing the amount of fiber she consumes can cause constipation and hemorrhoids in pregnancy, which can increase the discomfort and pain. Fiber is important for maintaining a healthy digestive system and preventing gestational diabetes and preeclampsia. The woman should consume at least 25 grams of fiber per day from fruits, vegetables, whole grains, beans, and nuts.

Choice D reason: Substituting other calcium sources for milk in her diet can deprive the woman and the baby of essential nutrients, such as protein, vitamin D, and riboflavin. Milk is not a common cause of heartburn in pregnancy, unless the woman is lactose intolerant or allergic to dairy products. The woman should consume at least three servings of dairy products per day or take calcium supplements as prescribed.

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What important, immediate postoperative care practice should the nurse remember when caring for a woman who has had a mastectomy?

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